Gross Anatomy-Deep Fascia

Question 1

Describe Deep Fascia

Answer 1

• Known as crural fascia
• Attaches to anterior and medial borders of tibia
• Continuous with periosteum
• Thick proximally, thinner distally
• Forms anterior and posterior intermuscular septa

Attach to fibula

Along with interosseous membrane, divides leg into 3 compartments:

• Anterior
• Lateral
• Posterior
  
  • • Further divided by transverse intermuscular septum
  • Separates superficial and deep posterior compartments

Question 2

Describe the forms of retinacula

Answer 2

• Thickened bands of fascia
• Bind tendons of anterior, lateral and posterior compartments before and after ankle joint
• Prevent bowstringing during ankle movements

Question 3

What are some of the Forms of Retinacula

Answer 3

Superior extensor retinaculum-

Inferior extensor retinaculum –

**Superior fibular retinaculum –

Inferior fibular retinaculum –**

**Flexor retinaculum- **

Question 4

Describe the Superior extensor retinaculum

Answer 4

 Found anteriorly

 Passes from fibula to tibia proximal to malleoli

Question 5

Describe the Inferior extensor retinaculum

Answer 5

 Found anteriorly
 Y-shaped band
 Attaches laterally to calcaneus, medially to medial malleolus and inferiorly to plantar aponeurosis
 Great saphenous v. and superficial fibular n. pass superficial to extensor retinacula

Question 6

Describe the Superior fibular retinaculum

Answer 6

 Found laterally
 From lateral malleolus to calcaneus

Question 7

Describe the Inferior fibular retinaculum

Answer 7

 Found laterally
 From fibular trochlea to calcaneus
 Both cover tt. of fibularis longus and brevis
 Small saphenous v. and sural n. pass superficial to fibular retinacula

Question 8

Describe the Flexor retinaculum

Answer 8

 Found medially
 Formed by distal part of transverse intermuscular septum
 Covers deep posterior compartment flexor tt.

Question 9

What are some Compartment Syndromes of Deep Fascia

Answer 9

• Increased pressure in confined anatomical spaces affects circulation

• Threatens function and viability of tissues
• Constitutes “compartment syndrome”

• Fascial compartments of lower limb are closed spaces

• Ending proximally and distally at joints

• Trauma to muscles and/or vessels in compartments may produce:

• Hemorrhage, edema, and inflammation of muscles
• Results in increased volume of compartment
• Strong fascia doesn’t allow accommodation
• Increases intra-compartmental pressure

• Pressures may reach levels high enough to:

• Compress structures in compartments concerned
  
  • Small vessels of muscles and nerves (vasa vasorum)
• Structures distal to compressed area become ischemic and may be permanently injured
  
  • Loss of motor function

• Loss of distal leg pulses is obvious sign of arterial compression

• Temperature of tissues may also be lowered

• Fasciotomy is performed to relieve pressure in compartment concerned

• Incision of overlying fascia or septum

*Also side note its when you get pinned inbetween two snomobiles and decide to wait to go to the hospital to find out that part of your leg is dead and needs to be cut out……only to find out you cannot participate in ballet =P

Question 10

When you smash your leg in between two snowmobiles what can happen?

Answer 10

“COMPARTMENT SYNDROME”

=]